A disability examiner who qualifies for the DEDA process (see DI 39563.900D) may complete the medical portion of the initial disability claim without an MC, including signing the medical assessment(s), Form SSA-416 (Medical Evaluation) and Form SSA-4734 (Physical Residual Functional Capacity (RFC) Assessment), and the overall medical signature when:

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  The adult initial sequential evaluation process applies. See DI 22001.001;

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  The medical assessment(s) of the claim is based on physical impairment(s) alone; and

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  The claimant is determined to be disabled with an established onset date (EOD) on or before the potential onset date (POD).

  IMPORTANT:

  If a mental impairment is alleged or discovered, and the determination is fully favorable based on only physical impairment(s), discontinue development when a fully favorable allowance is documented based on physical impairment(s). See DI 24505.030E.1.

  NOTE: 

  For Title XVI claims, the Field Office (FO) does not complete the POD field on the SSA-3367 (Disability Report – Field Office) if the protective filing date is the POD. For details, see DI 11005.045A.1.c. If the FO did not provide the POD in a Title II claim as required, send an assistance request to the FO to ask it to add the POD in EDCS using update-after-transfer (UAT) per DI 22501.002D. For information on the UAT utility, see DI 81010.095. For information on electronic assistance requests, see DI 81020.100.

DEDA authority cannot be used for the following claims:

1. a. 

   Claims that are less than fully favorable, that is, when the EOD is after the POD.

2. b. 

   Claims in which the evidence does not establish a fully favorable determination based on physical impairments alone.

3. c. 

   Claims in which a prior denial that is administratively final should be reopened and revised. For information on the conditions for reopening a final determination or decision, see DI 27505.001.

4. d. 

   Claims in which the favorable determination is based on medical equivalence.

5. e. 

   Title XVI childhood disability (DC) claims.

6. f. 

   Age 18 redeterminations (see temporary instructions in DI 39563.905 for exception).

7. g. 

   Reconsideration claims.

8. h. 

   Continuing disability review (CDR) cases. (see temporary instructions in DI 39563.905 for exception)

9. i. 

   Claims with potential fraud and similar fault

10. j. 

    Claims with potential DAA involvement that may have impacted physical disabling impairment.

IMPORTANT:If DEDA does not apply, do not apply a medical assessment(s) signed by an individual with DEDA signature authority to the Disability Determination Explanation (DDE).

Take the necessary steps within applicable State rules or regulations to raise State agency-level compensation to meet prevailing rates for MC services, if those services are unobtainable because of low salary rates or fee schedules.

Each State should also memorialize in writing and maintain records outlining the steps taken to raise compensation and document the controlling rules and regulations that may prevent further increases.

Advertise in at least two of the following channels when allocations or funding are available for additional hires and contractors:

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  State government website;

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  Recruitment sites, for example, Indeed, LinkedIn, or Handshake;

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  Newspapers;

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  Newsletters;

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  Medical journals;

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  Alumni websites or newsletters;

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  Medical association or organization websites; or

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  Contract recruitment services.

Complete at least two of the following recruitment activities when allocations or funding are available for travel or mail activities and for additional hires and contractors:

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  Recruit at medical professional organization meetings;

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  Recruit at health care summits;

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  Recruit during medical campus recruitment activities;

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  Send recruitment mailers to general groups of licensed physicians; or

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  Send recruitment mailers to alumni of different medical universities.

Offer at least one workplace flexibility, as allowed by State rules or regulations:

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  Telework;

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  Expanded shifts; or

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  Flexible working hours

Assign and require a current Chief MC or MC to perform peer recruitment outreach or activities within the State when allocations or funding are available for additional hires and contractors.

State DDSs should document and maintain records demonstrating recruitment activities, including any adversities that prevented recruitment. Send a copy of the documentation to the regional office Disability Program Administrator (DPA).

Examples of MC/PC recruitment adversities that may affect MC recruitment include:

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  The adjudicating site received insufficient or no hiring authority;

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  State-specific limitations prevent hiring;

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  The adjudicating site is at or over MC/PC capacity; or

The adjudicating site is providing MC/PC assistance to other State and federal adjudicating sites

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  Successfully completed disability examiner training and adjudicated adult cases for a minimum of 12 months. This is based on the expectation that the disability examiner has completed disability examiner training and worked with supervisors, mentors, and MCs long enough to develop the skills necessary to accurately analyze medical evidence and assess functional limitations related to physical impairments.

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  Demonstrated experience and autonomy in developing accurate medical assessments, that is, Form SSA-416 (Medical Evaluation) and Form SSA-4734 (Physical Residual Functional Capacity (RFC) Assessment).

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  Approval or endorsement from a supervisor or management official.

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  The adjudicating component has the authority to establish additional rules and guidelines according to internal DDS performance standards and quality expectations.

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  The adjudicating component must maintain appropriate documentation showing that:

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  The examiner meets the minimum qualifications; and

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  The additional parameters established by the DDS are met by each DEDA disability examiner.

Examples of documentation include, but are not limited to:

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  Probationary and performance review documents;

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  Internal Quality Assurance (IQA) and/or Federal Quality Assurance (FQA) statistics;

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  Records showing completion of training initiatives; and

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  Other relevant records.

Adjudicating sites assisting DDSs with case processing must verify that the State DDS they are assisting has met the “every reasonable effort” standard for MC recruitment and determine that their disability examiners meet the minimum qualification standards for DEDA authority.

Assisting adjudicating sites must document and maintain records identifying how the factors outlined in DI 39563.900 D in this section, Disability Examiner Qualifications for DEDA, were met.